MedPage Today: SGR Repeal Passes House; Patch Still Expected

WASHINGTON — A full repeal of Medicare’s sustainable growth rate (SGR) payment formula hit a snag Friday, but political insiders say another temporary stay from drastic cuts in Medicare reimbursement is likely on its way.

The House passed a bill in a 238-181 vote that repeals the SGR and replaces it with a systemthat rewards quality and provides incentives to physicians participating in alternative payment models. However, Republicans attached it to a measure that delays for 5 years the Affordable Care Act’s mandate requiring that all individuals obtain health insurance.

A total of 12 Democrats in the House were among those voting for the SGR repeal Friday. But with most Democrats in the Senate opposed to delaying the individual mandate, the bill is unlikely to ever come to a vote in that chamber. Furthermore, the White House has also threatened to veto the bill.

The Congressional Budget Office said a 5-year delay in the ACA’s individual mandate would save the government nearly $170 billion — providing more than enough money to pay for a full SGR repeal. Finding money to pay for the repeal has been lawmakers’ biggest hurdle to passing the measure.

Congress will almost assuredly pass some temporary patch to prevent 24% payment cuts in Medicare from taking effect on April 1, Joe Antos, PhD, health policy scholar at the American Enterprise Institute here, told MedPage Today. Physician groups including the American Medical Association have vehemently opposed a short-term patch and have instead lobbied for a full repeal.

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